煎药之法各殊∶有先煎主药一味,后入余药者,
有先煎众味,后煎一味者,有用一味煎汤以煎药者;
有先分煎,后并煎者;有宜多煎者(补药皆然);有
宜少煎者(散药皆然);有宜水少者;有不煎而泡渍
者;有煎而露一宿者;有宜用猛火者;有宜用缓火者;
各有妙义,不可移易。今则不论何药,惟用猛火多煎,
将芳香之气散尽,仅存浓浓之质。如煎烧酒者,将糟
久煮,则酒气全无矣,岂能和营达卫乎?须将古人所
定煎法,细细推究,而各当其宜,则取效尤捷。
其服药亦有法。古方一剂,必分三服,一日服三
次;并有日服三次,夜服三次者。盖药味入口,即行
于经络,驱邪养正,性过即已,岂容间断?今人则每
日服一次,病久药暂,此一暴十寒之道也。又有寒热
不得其宜,早暮不合其时,或与饮食相杂,或服药时
即劳动冒风,不惟无益,反能有害。至于伤寒及外症
痘症,病势一日屡变,今早用一剂,明晚更用一剂,
中间间隔两昼一夜,经络已传,病势益增矣。又发散
之剂,必暖覆令汗出,使邪从汗散;若不使出汗,则
外邪岂能内消?此皆浅易之理,医家病家,皆所宜知
也。又恶毒之药,不宜轻用。昔神农遍尝诸药而成本
草,故能深知其性。今之医者,于不常用之药,亦宜
细辨其气味,方不至于误用。若耳闻有此药,并未一
尝,又不细审古人用法,而辄以大剂灌之,病者服之
苦楚万状,并有因此而死者,而已亦茫然不知其何故;
若能每味亲尝,断不敢冒昧试人矣。此亦不可不知也。
The methods for decocting herbs vary: some require decocting a single principal herb first, then adding the remaining herbs; some require decocting multiple herbs first, then decocting a single herb last; some use the decoction of one herb to decoct other herbs; some are decocted separately first and then combined; some should be decocted longer (this applies to all tonifying formulas); some should be decocted briefly (this applies to all dispersing formulas); some require less water; some do not need decoction but only soaking; some should be left exposed overnight after decoction; some require strong fire; some require gentle fire. Each method has its subtle rationale and cannot be arbitrarily changed. Nowadays, regardless of the herbs, people only use strong fire and long decoction times, causing the aromatic qi to dissipate completely, leaving only a thick consistency. It is like distilling liquor; if the lees are boiled for too long, the liquor aroma will be entirely lost, how can it then harmonize Ying (Nutritive Qi) and Wei (Defensive Qi)? One must carefully study the decoction methods established by the ancients, ensuring each herb is treated appropriately, so that therapeutic effects will be achieved more swiftly.
There are also rules for taking medicine. Ancient prescriptions divided one dose into three servings, taken three times a day; there were also cases of taking medicine three times during the day and three times at night. Once the medicinal taste enters the mouth, it immediately circulates through the meridians, expelling pathogenic factors and supporting healthy qi. Its action ceases once its potency is exhausted; how can interruptions be tolerated? Modern people take medicine only once a day, with prolonged illness and brief treatment, which is akin to "exposing it for one day and freezing it for ten days" (inconsistent effort). Furthermore, improper regulation of cold and heat, incorrect timing in morning and evening, mixing with food, or exertion/exposure to wind immediately after taking medicine not only fails to help but may cause harm. Regarding Shanghan (Cold Damage) and external conditions such as smallpox, the disease status changes frequently within a day. If one dose is taken in the morning and another the next evening, with an interval of two days and nights, the pathogens have already transmitted through the meridians, and the disease severity increases. Additionally, dispersing formulas must be taken while keeping warm and covered to induce sweating, allowing pathogens to disperse through sweat; if sweating is not induced, how can external pathogens be eliminated internally? These are elementary principles that both physicians and patients should know. Moreover, toxic herbs should not be used lightly. In ancient times, Shennong tasted numerous herbs to compile the Bencao (Materia Medica), thus deeply understanding their properties. Contemporary physicians should also carefully distinguish the flavor and nature of rarely used herbs to avoid misuse. Merely hearing about a herb without tasting it oneself, and failing to carefully examine ancient usage methods, yet rashly administering large doses, causes patients immense suffering, and even death, while the physician remains ignorant of the cause. If every herb were tasted personally, no one would dare to recklessly test them on humans. This is also something one must know.